Senior Care Records.

Facility Evaluation Report

Nativity Care Home, INC., Union City06/23/2023Licence 019200472

Capacity6
Census6
Date signed06/23/2023 10:45:11 AM
The inspector’s account

On this day at around 9:15 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct a case management visit in connection with an incident reported by Regional Center of the East Bay (RCEB) when Client 1 (C1) sustained fracture in the upper arm. LPA met with Administrator Minnie Bagaoisan. LPA explained to Bagaoisan the purpose of visit.

During the visit, LPA obtained the following records for C1: Lic 601, SIR dated May 23, 2023, amended SIR, Seizure Chart, IPP and Physician's Report.

LPA will make a referral to IB to conduct investigation.

A copy of this report was provided to Administrator.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction